Sensory Processing Disorder (SPD)

Question 1

Sensory processing disorder can also be known as…

Answer 1

• sensory integrative problems
• sensory integration dysfunction

Question 2

Sensory processing disorder (SPD)

Answer 2

• not a specific problem
• group of patterns that emerge developmentally
• reflect differences in neural processing of sensory and motor systems (central nervous system, not peripheral)
• not currently identified as a disorder in the DSM
• all individuals process sensory information differently
• when it impacts occupations, that’s when it’s called SPD

Question 3

Comorbidities of sensory processing disorder

Answer 3

• autism
• ADHD
• trauma
• anxiety/depression
• obsessive-compulsive disorder
• stand alone difficulty

Question 4

Categories of sensory processing disorder

Answer 4

• sensory modulation problems
• sensory-based motor disorder
• sensory discrimination disorder
• praxis

Question 5

Sensory reactive continuum

Answer 5

• hyper reactive to sensory input
• hyporeactive to sensory input

Question 6

Sensory modulation occurs on a neurological threshold continuum

Answer 6

• under-responsive to input, high neurological threshold
• “just right” response to sensory stimuli
• over-responsive to sensory input, low neurological threshold
  *not always consistent across the systems

Question 7

Sensory modulation

Answer 7

• the ability to generate appropriate responses to sensory stimulation without over responding to under responding
• neurological thresholds = the amount of stimuli required for a neuron to respond
• nervous system responds quickly = low threshold for sensory input
• nervous system responds slowly = high threshold for sensory input

Question 8

Sensory modulation depends on…

Answer 8

• habituation
• sensitization

Question 9

Habituation

Answer 9

Recognizing familiar sensory information as unimportant

Question 10

Sensitization

Answer 10

Heightened awareness to important sensory stimuli

Question 11

Self-regulation

Answer 11

*an important skill
- the ability of people to manage their own needs in response to sensory input
- the ability to maintain a calm, alert state
- the awareness of and engagement in activities that keep one in a “just right” state for the activity
- may manage self-regulation by adding sensory input (ex: while studying, may be fidgeting, twirling hair, chewing fingernails, and listening to music to better attend)
- may manage self-regulation by reducing sensory input (ex: while studying, may need a quiet, distraction free environment)

Question 12

Sensory over-responsiveness (SOR)

Answer 12

• these children over respond to typical sensory input within the environment, hyper-respond to sensory input
• overwhelmed by typical sensory input and react strongly, often with anxiety
• may not habituate to sensory input (ex: feeling of clothing)
• they may have a low threshold for sensory input
• overwhelmed by typical sensory input and react strongly, often with anxiety
• these children are the easiest to identify because the behaviors are easy to notice and report
• common for when people to think of sensory processing problems to only think of sensory over-responsiveness

Question 13

Children can be over responsive in all sensory systems

Answer 13

• tactile over responsiveness
• vestibular over responsiveness
• auditory over responsiveness (cannot tolerate loud noises)
• over responsive to visual input
• over responsive to smell
• over sensitive to taste
• children who display over sensitivity in more than one sensory system are described as sensory defensive

Question 14

Tactile over responsiveness

Answer 14

Tactile defensiveness:
- hyperactive to ordinary touch
- light touch is aversive (tolerate deep touch better)
- self-applied input tolerated better than touched by others

Question 15

Vestibular over responsiveness

Answer 15

Gravitational insecurity:
- hyper reactive to vestibular input from the pull of gravity
- fear of movement
- moves slowly
- overwhelmed by changes in head position
- fear of heights
- decreased exploration
- feeling unsafe

Question 16

Children with sensory overload-responsiveness…

Answer 16

• have higher than typical levels of anxiety
• may be more emotional than typical peers with outbursts
• avoids certain environments

Question 17

Sensory under-responsiveness (SUR)

Answer 17

• these children are under-responsive (hyporesponsive) to typical sensory input within the environment
• high threshold for sensory input

Question 18

Children can be under-responsive in all sensory systems

Answer 18

• tactile
• vestibular
• proprioception
• visual
• auditory
• taste
• smell

Question 19

Behaviors of children with sensory under-responsiveness

Answer 19

• appear not to notice or respond to certain stimuli
• may appear lethargic (tactile)
• may not respond to sensations such as pain (tactile)
• may not notice when clothing is on incorrect or shoes are on wrong feet (tactile)
• may have poor fine motor skills (tactile/proprioceptive)
• may use too much or too little force to complete an activity (proprioception)
• may not actively explore environment
• may appear sensory seeking

Question 20

Sensory seeking behavior occurs for a variety of reasons…

Answer 20

• generate additional sensory input to compensate for inadequate discrimination
• regulate general arousal levels

Question 21

Sensory seeking behaviors include…

Answer 21

• engagement in increased movement throughout the day, described as “active” kids, running, jumping, and spinning
• engage in proprioceptive input such as hitting, banging, falling on purpose, and giving hugs
• appear to have “no fear”, risk takers
• tendency to touch items and people to the point of annoyance
• smell foods or objects
• put non-food items in mouth

Question 22

Non-modulation based sensory integration problems

Answer 22

• having a motor problem
• having underlying motor issues that are because of difficulties processing vestibular proprioception input

Question 23

Sensory discrimination

Answer 23

Brain’s ability to distinguish between different stimuli

Question 24

Sensory perception

Answer 24

Brain’s process of giving meaning to sensory information

Question 25

Sensory discrimination and perception

Answer 25

- can occur within any sensory system - sensory integration based OT is most appropriate for children with tactile and proprioception problems - when a visual-perceptual problem (difficulty recognizing the difference between d and b or p and g) is identified, an OT often uses a different approach, such as visual-perceptual training (a specific assessment of visual perceptual skills may be administered) - occurs in auditory perception is often referred to as speech-language pathologist - generally identified via clinical observations

Question 26

Observations of sensory discrimination and perception difficulties

Answer 26

- proprioception discrimination problem - tactile discrimination problem

Question 27

Proprioception discrimination problem

Answer 27

- difficulty interpreting body position and the position and movement of muscles and joints - clumsy, uses too much/too little force, seeks out proprioception, misjudges personal space

Question 28

Tactile discrimination problem

Answer 28

- difficulty interpreting the characteristics of tactile input (difficulties with stereognosis) - may have difficulty manipulating items so it impacts fine motor development - depends on visual system to guide participation

Question 29

Vestibular-bilateral dysfunction (sensory-based motor disorder)

Answer 29

- deficit is the inability to use two sides of the body together in a coordinated manner - a function of vestibular-proprioceptive processing - often demonstrates not other signs of sensory integration difficulties - difficulty with team sports, incoordination, and fine motor tasks

Question 30

Postural disorder (sensory-based motor disorder)

Answer 30

- difficulty with balance - deficits processing vestibular input - inefficient balance and equilibrium reactions - decreased trunk strength

Question 31

Dyspraxia

Answer 31

- DSM = developmental coordination disorder (DCD) - impaired ability to plan and execute non-habitual motor tasks - praxis - includes ideation and motor planning

Question 32

Praxis

Answer 32

The ability to conceptualize, plan, and execute a nonhabitual motor task

Question 33

Ideation

Answer 33

- the ability to generate ideas of what to do in a novel situation or conceiving play possibilities with novel toys - children may wander aimlessly, perform simple repetitive actions (such as patting or pushing items) or observe others to know what to do

Question 34

Motor planning

Answer 34

The ability to plan and execute the movement